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What characterizes the Taking-Hold Phase in postpartum women?
What characterizes the Taking-Hold Phase in postpartum women?
During which stage does the mother begin to adapt to her role as a parent?
During which stage does the mother begin to adapt to her role as a parent?
What is the primary focus of the Letting-Go Phase?
What is the primary focus of the Letting-Go Phase?
What does Maternal Role Attainment refer to?
What does Maternal Role Attainment refer to?
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Which of the following indicates the beginning of the Anticipatory Stage?
Which of the following indicates the beginning of the Anticipatory Stage?
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What emotional concerns may a mother express during the Taking-Hold Phase?
What emotional concerns may a mother express during the Taking-Hold Phase?
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How long does the Taking-Hold Phase typically last?
How long does the Taking-Hold Phase typically last?
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Which stage includes attending childbirth classes and selecting healthcare providers?
Which stage includes attending childbirth classes and selecting healthcare providers?
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What is the primary characteristic of 'Baby Blues'?
What is the primary characteristic of 'Baby Blues'?
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Which symptom is NOT typically associated with 'Baby Blues'?
Which symptom is NOT typically associated with 'Baby Blues'?
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What may cause an increase in blood pressure during the postpartum period?
What may cause an increase in blood pressure during the postpartum period?
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What should be done if 'Baby Blues' symptoms persist for more than ten days?
What should be done if 'Baby Blues' symptoms persist for more than ten days?
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At what point do symptoms of 'Baby Blues' typically peak?
At what point do symptoms of 'Baby Blues' typically peak?
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Which condition should be suspected if a woman's blood pressure is 140/90 mm Hg or higher postpartum?
Which condition should be suspected if a woman's blood pressure is 140/90 mm Hg or higher postpartum?
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What is the expected respiratory rate for a woman in the postpartum period?
What is the expected respiratory rate for a woman in the postpartum period?
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The three-stage role development process for fathers includes which of the following phases?
The three-stage role development process for fathers includes which of the following phases?
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What does tachycardia during the postpartum period suggest?
What does tachycardia during the postpartum period suggest?
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The primary emotional response during the 'Reality' phase is typically characterized by:
The primary emotional response during the 'Reality' phase is typically characterized by:
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What does 'engrossment' refer to in the context of fathers?
What does 'engrossment' refer to in the context of fathers?
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What action should be taken if there is an abnormal temperature after 24 hours postpartum?
What action should be taken if there is an abnormal temperature after 24 hours postpartum?
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What may indicate pulmonary complications in a postpartum patient?
What may indicate pulmonary complications in a postpartum patient?
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Which of the following is a treatment strategy for 'Baby Blues'?
Which of the following is a treatment strategy for 'Baby Blues'?
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What is the typical range for bradycardia in a postpartum period?
What is the typical range for bradycardia in a postpartum period?
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What should be monitored regarding pain in a postpartum mother?
What should be monitored regarding pain in a postpartum mother?
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What is the primary characteristic of Lochia Rubra?
What is the primary characteristic of Lochia Rubra?
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How much total lochia discharge is typically expected postpartum?
How much total lochia discharge is typically expected postpartum?
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What color indicates Lochia Serosa?
What color indicates Lochia Serosa?
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Which degree of perineal laceration involves the external anal sphincter?
Which degree of perineal laceration involves the external anal sphincter?
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Which component of the REEDA assessment evaluates the approximation of the episiotomy?
Which component of the REEDA assessment evaluates the approximation of the episiotomy?
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What is a positive Homan's sign indicative of?
What is a positive Homan's sign indicative of?
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What type of discharge characterizes Lochia Alba?
What type of discharge characterizes Lochia Alba?
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Which statement about lochia discharge in women who had a cesarean birth is true?
Which statement about lochia discharge in women who had a cesarean birth is true?
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What is the primary goal of pain management for a woman postpartum?
What is the primary goal of pain management for a woman postpartum?
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How does oxytocin affect milk production in breastfeeding mothers?
How does oxytocin affect milk production in breastfeeding mothers?
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When can menstruation typically occur for non-breastfeeding mothers after childbirth?
When can menstruation typically occur for non-breastfeeding mothers after childbirth?
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What might cause an increase in white blood cells postpartum?
What might cause an increase in white blood cells postpartum?
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What is the effect of deep vein thrombosis in postpartum care?
What is the effect of deep vein thrombosis in postpartum care?
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Which factor contributes to the rapid filling of the bladder within 12 hours after birth?
Which factor contributes to the rapid filling of the bladder within 12 hours after birth?
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What typically occurs to a woman's blood volume after childbirth within 3 weeks?
What typically occurs to a woman's blood volume after childbirth within 3 weeks?
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As the placenta is expelled, which hormone is activated to ensure milk production?
As the placenta is expelled, which hormone is activated to ensure milk production?
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Study Notes
Postpartum Adaptations
- Women may have difficulty adjusting to unfamiliar procedures and negative birth experiences.
- They require continued attention and care for their physical and psychological needs.
Taking-Hold Phase
- Occurs on the second to third day postpartum and may last several weeks.
- Mothers are concerned about their health, the infant's condition, and their ability to care for their newborn.
- They demonstrate independence by caring for themselves and learning to care for their infant but still need reassurance.
- May express anxiety about their competence as a mother.
- This phase is considered the "teachable, reachable, referable moment."
Letting-Go Phase
- Mother re-establishes relationships with others.
- Adapts to parenthood by assuming the new role of a mother.
- Takes responsibility and care for the newborn with more confidence.
- Focuses on moving forward by assuming the parental role and separating from the symbiotic relationship with their newborn.
Maternal Role Attainment
- An ongoing process where mothers gain confidence in caring for their infants and embrace their identity as a mother.
- Begins during pregnancy and continues for several months after childbirth.
Stages of Maternal Role Attainment
- Anticipatory Stage: Starts during pregnancy with choosing a physician, attending childbirth classes, and seeking role models for learning the maternal role.
- Formal Stage: This stage marks the beginning of motherhood.
- Informal Stage: Mothers adjust and integrate their new role into their daily lives.
- Personal Stage: Mothers accept and integrate their new identity.
Maternal Blues/Baby Blues
- A normal reaction to the hormonal changes after childbirth, including the abrupt withdrawal of estrogen, progesterone, and cortisol.
- Symptoms include tearfulness, mood swings, insomnia, fatigue, anxiety, difficulty concentrating, irritability, and poor appetite.
- Usually begins within the first few days postpartum, peaks on the fifth day, and subsides within a few days.
- Does not affect the woman's ability to care for herself, her newborn, or her family.
- Treated with support and reassurance.
Partner Psychological Adaptations
- Engrossment: The father's developing bond with the newborn, characterized by intense absorption, preoccupation, and interest.
Three-Stage Role Development Process for Partners
- Expectations: Partners have preconceptions about what home life will be like with a newborn.
- Reality: Partners realize that their expectations are not realistic, leading to feelings of sadness, ambivalence, jealousy, and frustration.
- Transition to Mastery: Partners transition to a more confident and capable role in caring for the newborn.
Lochia
- Discharge from the uterus consisting of blood from the placental site and debris from the decidua.
- Total volume: 240 to 270 mL.
- Cesarean births result in less lochia discharge, but the stages and color changes remain the same.
Lochia Stages
- Lochia Rubra: Occurs during the first few days postpartum, mainly consists of blood, and is red in color.
- Lochia Serosa: Present after 3-4 days, pinkish-brownish in color.
- Lochia Alba: White/yellow-white thick discharge.
Episiotomy
- A surgical incision made in the muscular area between the vagina and the anus to enlarge the vaginal opening before birth.
Perineal Lacerations
- Classified by degrees to describe the amount of tissue involved:
- 1st Degree: Superficial vaginal mucosa or perineal skin.
- 2nd Degree: Involves the vaginal mucosa, perineal skin, fascia, and muscles of the perineum.
- 3rd Degree: Extends into or through the external anal sphincter.
- 4th Degree: Extends through the external anal sphincter and into the rectal mucosa.
REEDA Assessment for Episiotomy
- R: Redness
- E: Edema
- E: Ecchymosis
- D: Drainage or Discharge
- A: Approximation of the Episiotomy
Postpartum Assessment: SHEBS
- S: Sexuality
- H: Homan's Sign
- E: Emotional Status
- B: Bonding
- S: Spiritual/Support System
Vital Signs
-
Temperature:
- Normal in the first 24 hours.
- Slight fever may occur due to dehydration during childbirth.
- Temperature should be normal after 24 hours with fluid replacement.
- Abnormal temperature after 24 hours may indicate infection and requires reporting.
-
Pulse:
- Relative bradycardia may be observed due to changes in blood volume and cardiac output.
- May range from 50-70 bpm.
- Usually stabilizes to pre-pregnancy levels within 10 days.
- Tachycardia can suggest anxiety, excitement, fatigue, pain, excessive blood loss, infection, or underlying cardiac problems.
-
Respiration:
- Should be within the normal range of 16-20 breaths per minute.
- Any changes in respiratory rate may indicate pulmonary edema, atelectasis, or pulmonary embolism and require reporting.
- Lungs should be clear on auscultation.
-
Blood Pressure:
- Postpartum BP should be compared to pre-delivery readings.
- Increases from baseline could be caused by pain or anxiety.
- If BP is 140/90 mm Hg or higher, preeclampsia may be present.
- Decreases may indicate dehydration or hypovolemia resulting from excessive bleeding.
- May vary based on the woman's position; take BP in the same position each time.
- Orthostatic hypotension can occur when a woman quickly changes from lying or sitting to standing.
-
Pain:
- Mother should rate pain from 0 to 10 points.
- Pain relief should be routinely administered to prevent pain.
- Goal of pain management: Maintain pain scale ratings between 0 to 2 points at all times, especially after breastfeeding.
Systemic Changes During Puerperium
- Menstruation resumes about 6 weeks after birth in non-breastfeeding mothers and up to 24 weeks in breastfeeding mothers.
- Luteinizing hormone of the anterior pituitary is activated after placenta expulsion; prolactin stimulates milk production.
- Oxytocin initiates the let-down reflex, enabling milk flow and facilitating the baby's milk intake.
Circulatory System
- Blood volume returns to pre-pregnant levels after 3 weeks.
- Cardiac output declines by 30% in the first two weeks and normalizes by 6-12 weeks.
- Heparin followed by warfarin may be prescribed for deep vein thrombosis (DVT).
- WBC count may increase to 30,000/mm3 if labor was prolonged and typically returns to normal values within 6 days.
Excretory System
- Factors contributing to rapid bladder filling within 12 hours of birth:
- Large amounts of intravenous fluids given during labor.
- Decreasing antidiuretic effect of oxytocin.
- Buildup and retention of extra fluids during pregnancy.
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Description
Explore the critical phases of postpartum adaptation, including the Taking-Hold and Letting-Go phases. Understand how new mothers navigate their health concerns and parental responsibilities while seeking reassurance and support. This quiz will cover the emotional and physical transitions in early motherhood.
